Who's Who in the NICU

If your little one needs to spend time in the NICU, you’ll run into quite a few people while she’s there. Here are the staff members you might meet and how they’re helping you and your baby.

The Neonatal Intensive Care Unit (more often called simply the “NICU”) is a special area of the hospital designated for infants who need more in-depth medical attention. Your baby might be admitted to the NICU — be it for just a few hours or a longer stretch of time — for low birth weight, neonatal jaundice, meconium aspiration syndrome or an infection. Or if your baby is among the approximately 11 percent of those born prematurely — that is before 37 weeks — she’ll be admitted for extra monitoring and care. When she arrives, a team of experts will be there to help ensure she’s as healthy as possible by monitoring and supporting her still-developing body systems. Seeing your tiny one surrounded by machines and tubes in a sterile and busy environment can feel overwhelming. But rest assured, the NICU is staffed by expert doctors, nurses and other specialists who will not only attend to your baby’s every need but will also become your closest partners in her care.

Who Works in the NICU?

Parents are usually invited to join the daily “rounds,” meetings where doctors visit each baby to discuss next treatment steps. Rounds are the best time for you to ask questions and to share observations and opinions — a vital part of your baby’s care. Here are some of the team members you may meet in the NICU:

Neonatal nurses

At baby’s bedside day and night, neonatal nurses do everything: Change diapers; insert and monitor IVs; navigate tubes so you can pick up your baby once the doctor gives the all-clear for cuddling. Your nurse will also help you communicate with other members of the clinical team, relaying your messages to doctors as they travel around the hospital. Since nurses spend so much time with your baby in the NICU — often 8 and 12-hour shifts at a time — they’ll become the go-to people on your support system. Not only are they trained to care for special-needs babies, but they’re also experts in reassuring and supporting brand-new parents.

Neonatologists

These doctors are board-certified specialists in neonatal and perinatal medicine. In other words, they’re the world’s experts in caring for newborns — particularly preemies — and they’ll make many of the important diagnosis and treatment decisions for your baby.

Respiratory therapists

Nutritionists

If your baby is getting her nutrition through an IV, a nutritionist may be on hand to monitor the blend of nutrients and caloric intake — and eventually to transition your baby from an IV to breast milk or formula.

Lactation consultant

Since babies in the NICU may have breastfeeding challenges — either because of physical limitations like weak sucking or because they’re still too young to be held — a lactation consultant will be on hand to help you pump and store your breast milk. This keeps your milk supply flowing and ensures that when your baby is ready, she can drink your milk from your breast or a bottle.

Occupational therapists

Physical therapists

Physical therapists help your baby’s joint and muscle mobility. Since babies born early have low muscle tone, physical therapists can help position and move them so they don’t develop tight muscles.

Social worker/mental health specialists

Having your child in the NICU can be an emotional experience. Stress, fear, sadness, shock, frustration and confusion — as well as hope and happiness as your baby’s health improves — are all common emotions among NICU parents. Social workers are there to help you through it by offering support groups and other forms of therapy; talking with others who understand what you’re going through can help you to feel less alone. Social workers also help connect you with services your baby may need at home, such as special prescriptions, in-home nursing care or appointments with developmental specialists.

Medical practitioners in training

If your baby is in an academic training center, she’ll also be cared for by fellows who have completed a pediatric residency and are now training to specialize in neonatology. You may also meet residents, who do shorter rotations through the NICU as part of their pediatric training, as well as post-residency doctors spending a year in the NICU before committing to a full fellowship.

Note that not all of these practitioners will necessarily assist your baby, and others — including cardiologists, surgeons, neonatal nurse practitioners (NPs), physician assistants (PAs) and house physicians — may care for her as well.

Getting Help When Baby Goes Home

When doctors consider your baby to be stable, you’ll hear four magic words: “Time to go home!” Your hospital team will provide a written discharge summary with all the details of what the baby will need at home — plus contact information should you have questions. They’ll also make sure your baby has an appointment scheduled with a pediatrician and any other specialists as necessary.

After a complicated and emotional time in the NICU, the most important thing to focus on when your premature baby comes home is to give her a warm, calm and loving environment. Call on family and friends for help with the laundry and cooking, so you can focus on what you’ve wanted to do all along: Simply hold your little bundle in the comfort of your own — and your baby’s brand new — home.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.